Heart Attack and Stroke Signs in Black Adults

Heart attack and stroke are two separate diseases that are closely related. They often share the same underlying risk factors, causes, and mechanisms, such as plaque buildup (atherosclerosis) and blood clots. Experiencing one increases the risk of the other.

A heart attack happens when the blood flow to the heart muscles is blocked, while a stroke results from the interruption of blood flow to the brain. In other words, the two conditions result from the starvation of oxygen supply to vital organs; the heart (heart attack) and the brain (stroke). Both of these conditions are potentially fatal and require emergency intervention.

Cardiovascular disease remains the leading cause of death in the United States, claiming approximately 2,400 lives each day, according to the American Heart Association. Within the Black community, 10.2% of adults have heart diseases, 31.7% live with hypertension, and 3.7% have experienced a stroke, according to Florida State University. Black adults are also nearly 30% more likely to die from heart disease compared to our white counterparts.

The American Heart Association further reports that nearly 60% of Black adults in the United States have some form of cardiovascular disease—significantly higher than the 49% national average. Although the warning signs of heart attack and stroke are widely known, symptoms may present differently and are often underrecognized in our community compared to the classic clinical portrayals.  

How Symptoms in the Black Community May Differ

Heart attack and stroke are both life-or-death emergencies. The time it takes to get medical intervention counts towards a positive or negative outcome. Understanding the warning signs and symptoms can help you to get help faster. The common signs of a heart attack include:

• Distressing pressure or pain in the center of your chest
• Pain or discomfort in one or both arms, jaw, neck, back, or stomach
• Shortness of breath, with or without chest pain
• Sudden abnormal sweating, lightheadedness, or nausea

Specific Stroke Symptoms in the Black Community

The core emergency symptoms for stroke are F.A.S.T., which represents Face drooping, Arm weakness, Speech difficulty, and Time. However, Black adults may experience specific symptoms like unilateral weakness or numbness.

Also, adults in our community have been shown to be less likely to recognize certain stroke symptoms, such as trouble speaking and sudden confusion, which may lead to a delay in seeking medical attention. This is due to lack of awareness on specific warning signs and atypical presentation of symptoms.

Specific Heart Attack Symptoms among Black Patients

Adults in our community are more likely to experience shortness of breath and pain in the upper body, rather than just the chest. Black women are more likely to experience “silent” or atypical heart attack symptoms.

In other words, our women may present a wider range of symptoms that may not immediately suggest a heart issue. Specific atypical heart attack symptoms experienced by Black women include:

1. Unexplained tiredness: Extreme fatigue, even without significant physical activity, is an early warning symptom in Black women.
2. Heart racing (palpitations): Tension or anxiety can make the heart race. However, if this occurs frequently for no reason, it should be a source of concern.
3. Headache and shoulder pain: This common symptom in Black women is often either overlooked or misdiagnosed.
4. Indigestion or stomach pain: Black women who suffer a heart attack have frequently reported this symptom, which is often mistaken for an ulcer or food poisoning.

Reasons for High Prevalence and Mortality in Black Community

Black adults have higher rates of diseases that place them at risk of heart attack and stroke. For example, we have higher rates of hypertension (which in some cases develops early), diabetes, and obesity. These diseases can change how stroke and heart attack symptoms present.

The fact that the underlying health challenges in our community can mask the symptoms of heart attack and stroke makes it harder for the victims to seek timely medical care. Even when we seek care, often times we are misdiagnosed or undertreated. Misdiagnosis rate is as high as 17.5% for stroke and 1.5% for heart attack. The delay in accessing care increases the risk of death and disability from these diseases.

Socioeconomic factors

Systemic racism has left predominantly Black communities in the United States with fewer social amenities, including healthcare services. Consequently, Black adults may face more hurdles getting access to quality healthcare.

Systemic racism also extends to how employment opportunities are distributed. Our adults are more likely to be engaged in more mentally and physically demanding jobs, which can lead to higher rates of stress, exacerbating the risk of heart attack and stroke.

Lifestyle factors

Several lifestyle habits predispose our people to heart attack and stroke. One of them is the high consumption of a “Southern diet” like soul food. Some of these cuisines have high sodium, fat, and sugar content, which contributes to weight gain and hypertension.

Also, fewer than half of Black adults on average meet the recommended weekly physical activity goal. Adults are recommended to perform at least 30 minutes of moderate-intensity aerobic exercise 5 days a week or 25 minutes of vigorous activity 3 days a week.

Lack of time (tied up trying to make ends meet) and environmental constraints (lack of recreational amenities in Black communities due to systemic racism) contribute to this factor.

How Black Adults Can Beat Heart Attack and Stroke Odds

The odds are stacked against Black adults when it comes to heart attack and stroke, starting with our genetic makeup. However, the first step towards winning the invisible battle is learning to understand and trust our body. If you don’t feel OK, seek care immediately, rather than dismissing or diminishing your symptoms.

More than ever, we should be more intentional about our heart health, especially with the rising mortality and disabilities from heart attack and stroke. It starts with knowing the factors that increase your risk of these diseases. Here’s a checklist that can help you live more intentionally:

• Prepare your own meals: Have a meal plan for the week or month, since you don’t have control over food content when you eat out. Cut down the sodium and sugar content of your meal
• Plan active daily times: Mindful of the daily recommended exercise duration for optimal health, plan active times that will incorporate aerobics. The activities can either be done indoors or outdoors
• Plan annual checkups: Book an appointment with your healthcare provider to get checked, especially if you are in your mid-thirties and above
• Leverage health technologies: Smartwatches and other wearable health devices can monitor your vitals and notify you of warning signs before they become obvious

Practice self-care to keep your heart healthy, including engaging in physical activity, eating healthy, getting enough sleep, and finding creative ways to reduce stress, like adopting pets that will force you to spend more time outdoors. Remember you don’t have to do that alone. You can join a group like the Black Heart Association for free screenings and heart education.

For More Reading

1. Center on Better Health and Life for Underserved Populations. (n.d.). Cardiovascular disease in African Americans. Florida State University. https://bhlcenter.fsu.edu/reducing-cvd-risk-project/cardiovascular-disease-african-americans
2. American Heart Association. (2022). Heart disease and stroke statistics—2022 update: Black race and cardiovascular disease (fact sheet).https://professional.heart.org/-/media/PHD-Files-2/Science-News/2/2022-Heart-and-Stroke-Stat-Update/2022-Stat-Update-factsheet-Black-Race-and-CVD.pdf
3. Carnethon, M. R., Pu, J., Howard, G., Albert, M. A., Anderson, C. A. M., Bertoni, A. G., Mujahid, M. S., Palaniappan, L., Taylor, H. A., Willis, M., Yancy, C. W., & American Heart Association Council on Epidemiology and Prevention. (2017). Cardiovascular health in African Americans: A scientific statement from the American Heart Association. Circulation, 136(21), e393–e423. https://pmc.ncbi.nlm.nih.gov/articles/PMC4082800/
4. Preventive Cardiovascular Nurses Association. (2023, February 14). Heart attacks in Black women. PCNA. https://pcna.net/news/heart-attacks-in-black-women/
5. Emecheta, A. (2026, January 6). Can AI detect birth defects? Elevate Black Health. https://www.elevateblackhealth.com/can-ai-detect-birth-defects/
6. Emecheta, A. (2025, October 30). Reclaiming outdoor space with pets. Elevate Black Health. https://www.elevateblackhealth.com/reclaiming-outdoor-space-with-pets/
7. Emecheta, A. (2025, December 12). Fighting caregiver burnout with technology. Elevate Black Health. https://www.elevateblackhealth.com/fighting-caregiver-burnout-with-technology/
8. Emecheta, A. (2025, November 18). Diabetes made simple: A quick guide. Elevate Black Health. https://www.elevateblackhealth.com/diabetes-made-simple-a-quick-guide/
9. Emecheta, A. (2025, September 22). Causes, effects, and prevention of obesity in Black men. Elevate Black Health. https://www.elevateblackhealth.com/causes-effects-and-prevention-of-obesity-in-black-men/
10. Szabo, L. (2024, January 31). Women and people of color bear the brunt of medical misdiagnosis. The 19th. https://19thnews.org/2024/01/women-and-people-of-color-medical-misdiagnosis/